HOW TO PRACTICE

O.T.C
Lecture two
 Fever
yes
Vomiting & diarrhea Gastroenteritis & appendicitis
No yes
Cough& dyspnea Respiratory infection
No
yes
Sneezing, fatigue, rhinorrhea Common cold
No
yes
Pain on urination renal infection
No
yes
Teething period< 2 y Teething fever
No
antipyrtic
 Body temperature
: measurements
: ”Oral “sublingualْ
Good reflex of body temperature but usually lower than
body temp due to breathing from mouth while taking
.temp

:Tympanic
Due to high blood flow in tympanic membrane,
.so reflects body temp

Axillaries
.But its validity is questionable
 Treatment
Supportive
Cool bath, ice packs, fans reduce fever

: Antipyretic
acetaminophen, Ibuprofen, ketoprofen or
aspirin, declofenac

Antipyrtic should be taken after meal

NB: Aspirin should be avoided in children lower than

12 years due to risk Ray’s syndrome
paracetamol
 Ibuprofen

ketoprofen
declofenac
 Example of OTC prescription

Pyral syrp
‫ مرات بعد االكل‬3 ‫ مل‬10
 headache
yes
Eye pain, blurred vision Eye problem
No yes
Sinus congestion, pain in sinus areas sinusitis
No
yes
Throbbing pain in one side of head migraine
worsen with normal movements,

No
Give analgesic
Like fever
 Prevention of headache

avoid high amount of caffee, tea, ice -1

cream, chocolate

avoid stress and avoid change normal-2

”routine as “dieting, traveling, sleeping
 Treatment of migraine

: Mild cases
Acetaminophen plus metoclopramide

:Sever cases
Ergotamine combination
Avoid use in hypertensive patients or pregnant
 Paracetamol +
metoclopramide
ergotamine
 Example of OTC prescription for migrain

Migracid tab
‫ قرص عند اللزوم‬1-2
 insomnia
yes
Psychological causes or sever pain Physician contact
No
yes
On starting drug use Drug induced
No
Give first generation antihistaminic
or natural sedating product
”Prevention of insomnia “sleep hygiene

avoid CNS stimulant drugs-1

Hunger can inhibit sleep, so not go to-2

.bed hungry

Avoid coffee, smoking completely after-3

.noon

Bed room should be comfortable-4

avoid napping-5
 Treatment
: Antihistaminic
as diphenhydramine & doxylamine at
bedtime

: Plant extracts
® Valerians (Dormival)
® Kava kava extract (kava)
Plant extracts
First gen. antihistaminic
:Example of OTC prescription

Kava cap
‫ كبسوالت يوميا ً قبل النوم‬2 – 1
Avil retard tab
‫قرص يوميا ً قبل النو م‬
 Fatigue & weakness
yes
Fever & rhinorhea, sneezing Common cold
No
yes
Recurrent Hypotension, palpitation, pale skin anemia
No
Unintended potent weight loss, good yes hyperthyroidism
appetite, sweeting, tachycardia, nervousness
No
yes
On starting drug use Drug induced

Overworking or under eating is the cause

 Treatment: “for fatigue & weakness

:Caffeine stimulant-1
NB: too much caffeine may cause nervousness,
.irritability & no sleep

multivitamins-2
Supply vitamins and minerals and energizers-
Avoid those concentrate on iron or calcium-
Multivitamins are taken once daily after meal-
 multivitamins
royal jelly -1

vitamins and minerals -2

ginseng -2

wheat germ oil -4

antioxidant -5

Bee pollen -6
multivitamins
:Example of OTC prescription

Royal jelly 600 mg tab

‫كبسولة يوميا ً بعد الغداء‬
 Back pain
yes
Accident, fall, injury physician
No
yes
Urine problem Renal stone or infection
No yes
Numbness or pain in one leg Sciatica (disc)
No
Chronic pain, inflammation,
yes Osteoarthritis or
stiffness In both sides of joints rheumatic arthritis

Give analgesic, muscle relaxant

 Treatment of back pain
:analgesic -1
acetaminophen, Ibuprofen, ketoprofen or aspirin,
declofenac, piroxicam,celecoxib, nimasulide,
indomethacin

muscle relaxnt-2
.®EX 1 :- Baclofen(Baclofen)
.® EX 2 :- Chlozoxazone (Myolgine)
.® EX 3:- Orphenadrine (Norflex)

counter irritant-3
Mask the pain
Not applied to wound or damaged skin
indomethacin

AntiCox 2
Muscle relaxant and analgesic
:Example of OTC prescription

myolgin cap
‫ مرات بعد االكل‬3 ‫كبسولة‬
Olfen amp
‫حقنة عضل يوميا‬
 cough
yes
Fever Respiratory infection
No
yes
Asthmatic patient Physician contact
No
yes yes cough
Productive Interfere with sleep or suppressant +
activity or painful expectorant
No
dry cough
No

yes Give
mucolytic or
Give antitussive expectorant
 Cough

Cough removes foreign bodies, so not

recommend selling a cough suppressant to
.smokers

Productive cough brings up accumulated

mucus preventing pneumonia, so must be
allowed to be continued for its cleansing
effect
 Treatment productive cough
®Bromohexyine (Bisolvon)

®Ambroxol (Ambroxol)
Active metabolite of bromohexine

Acetyl cystiene: (Acetyl cystiene) ® Powder

:Carboxy methyl cystiene ( solvex)

mucolytic
mucolytic
 Treatment of dry cough
Cough suppressant ( antitussive)
: Central
codeine Diphenhydramine; Dextromethorphane;
Noscapine”, Pipozethate, Butamirate

: Peripheral
camphor & Menthol

Codeine&Dextromethorphane have the risk of abuse

.( addiction)& constipation
antitussive
antitussive
Expectorant & cough suppressant

Guaifensin Diphenhydramine

Ammonium cl ;Dextromethorphane

Tr. Ipeca
Camphor
Tr. Squill
”Menthol
KI
Antitussive+ expectorant
 Natural preparations for cough

They act as cough suppressant and expectorant

:Examples
Guava leaves, fennel, thyme, honey, tilia,
.comphor, mentol

Suitable for pregnant, patients with kideny, liver

.disorder
Natural cough product
Example of OTC prescription for
:productive cough

muco syrup
‫ مرات‬3 ‫معلقة كبير\ة بعد االكل‬
Example of OTC prescription for
:Dry cough

sinecode syrup
‫ مرات‬3 ‫معلقة كبير\ة بعد االكل‬
Example of OTC prescription for
:Combination Drug for cough

Toplexil syrup
‫ مرات‬3 ‫معلقة كبير\ة بعد االكل‬